Integrating oral health into pediatric nursing practice: Caring for kids where they live

Teaching Preschool Children Correct Toothbrushing Habits Through Playful Learning Interventions: A Randomized Controlled Trial

PURPOSE

This study aimed to investigate the effect of playful learning interventions (with toys, visual and auditory sources) on appropriate toothbrushing behaviors and the amount of accumulated plaque in preschool children.

DESIGN AND METHODS

The study was carried out as a parallel-group, randomized and controlled study during the period October-December 2018, with 100 preschool children. The preschool students were randomly assigned to an intervention and a control group. The children in the intervention group were given instructions on how to brush their teeth while the children in the control group were not given any instruction outside of what they had learned in preschool. The playful learning interventions that were carried out consisted of three rounds of meetings designed to educate the children about adopting appropriate toothbrushing behaviors.

RESULTS

The study groups were well matched at baseline (p = .537) and the intervention group showed statistically significant improvements in toothbrushing (p = .001) and plaque control (p = .001) following the intervention in comparison to the controls. Additionally, while the amount of plaque decreased in the children in the intervention group (p = .001), plaque increased in the control group after the intervention (p = .001).

CONCLUSIONS

This study showed that after the playful learning interventions carried out with the preschool children, appropriate toothbrushing behaviors were acquired and there was a decrease in the amount of plaque.

APPLICATION TO PRACTICE

Nurses who work with preschool children could use toys and songs as effective and entertaining nursing interventions for developing correct toothbrushing behaviors.

An exploration of student nurses' views of oral health care in the hospitalised child: A qualitative study

Hospitalization impacts negatively on oral health, where underlying medical conditions and interventions such as oxygen therapy and nil-by-mouth status increase susceptibility to complications. However, evidence suggests it is often overlooked, or viewed as low priority by nurses. The rationale for these beliefs is unclear. This study provides an exploration of these beliefs, focusing specifically on their development, as reflected in the experiences of adult and paediatric student nurses. Three focus groups were conducted, and thematic analysis applied. Whilst students theoretically understood the value of oral health care, in hospital it was overlooked, with other 'clinical' aspects of care valued more highly. 'Hierarchy of need' emerged as the over-arching theme. Interrelated sub-themes included: 'practice/theory mismatch,' highlighting lack of education and adequacy of exposure to oral health care encounters; 'resources,' where infrastructure was lacking; and 'disempowerment,' where students felt powerless to act. Exposure to oral health care encounters were less frequent in the paediatric setting, risking disempowerment of parents as well as students. These findings highlight the need to raise the profile of oral health care, both theoretically and practically, engendering a culture that embeds mouth care unobtrusively into day-to-day nursing practice, improving health care outcomes for those in our care.

Parental Consent and Access to Oral Health Care for Adolescents

While most states allow minors 12 years and older to consent to services for contraception, prenatal care, or sexually transmitted infections, the same adolescents are required to have parental consent for even preventive oral health care. Many adolescents are denied access to preventive oral health care because of the challenge of securing parental consent for care when parents are unwilling, unable, or unavailable to consent. Our purpose is to examine the barriers to preventive oral health care for U.S. adolescents related to parental consent laws, explore the issues surrounding these laws, and recommend policy changes. We explain the current range and status of consent laws across the country and arguments for parental consent law as it now stands. We discuss the difficulty of applying general medical consent law to preventive oral health care, neuroscience research on cognitive capacity among adolescents, and the distinction between parental consent and adolescent assent. We recommend replacing required "opt-in" consent with simpler "opt-out" consent; developing a tool for assessing adolescent decision-making capacity; advocating for consent laws that apply specifically to preventive oral health care; and empowering school nurses to lead local, state, and nationwide policy and legislation efforts.

Integrating Maternal and Children's Oral Health Promotion into Nursing and Midwifery Practice- A Systematic Review

BACKGROUND

Globally, oral diseases contribute to major disease problems and oral health disparities persistently exist amongst vulnerable population groups. Two contributory factors to these challenges are the shortage of dental practitioners and the characteristic separation between the medical and dental professions. Nurses and midwives, in particular, are in a potentially excellent position to assist in basic oral health services such as dental health education and intraoral screening. We aimed to assess the effectiveness of integrating promotion of oral health of young children and their mothers into nursing and midwifery practice.

METHODS AND FINDINGS

Seven electronic databases including CENTRAL, EMBASE, MEDLINE, GLOBAL HEALTH, CINHAL, Scopus, and Web of Science were systematically searched whereas conference proceedings and theses were retrieved via PROQUEST. Only randomized, non-randomized trials and observational studies on preventive oral health programs delivered by nurses or midwives in healthcare settings or through home visits were included. Two investigators reviewed full-text articles independently to decide on eligibility for inclusion. Quality assessment was done using Cochrane tool for risk of bias for randomized trials and Downs and Black assessment tool for all other studies. Out of 3162 retrieved records, twenty one trials on oral health interventions incorporated into standard nursing practice were reviewed. Eighteen programs reported significant positive outcomes including reduction in caries experience, better oral hygiene and dietary habits and increased rates of dental visits amongst young children as reported by their caregivers.

CONCLUSIONS

Incorporating oral health promotion into nursing practice is a promising initiative for reducing oral health disparities by contributing to a downward trend in caries experience and increased access to dental care especially amongst the poor disadvantaged communities.